Paul Kelly, is a
Psychologist - Cognitive & Behavioral based in Chicago, Illinois. Paul Kelly is licensed to practice in * (Not Available) (license number ) and his current practice location is
7921 S Trumbull Ave, Chicago, Illinois. He can be reached at his office (for appointments etc.) via phone at
(708) 728-5460.
NPI number for Paul Kelly is 1629773478 and his current mailing address is 7921 S Trumbull Ave, Chicago, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1629773478.
Healthcare Provider's Profile
Full Name | Paul Kelly |
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Gender | Male |
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Speciality | Psychologist - Cognitive & Behavioral |
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Location | 7921 S Trumbull Ave, Chicago, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1629773478
- Provider Enumeration Date: 04/03/2023
- Last Update Date: 11/01/2024
Medical Identifiers
Medical identifiers for Paul Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1629773478 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 178020309 (Illinois) | Secondary |
103TB0200X | Psychologist - Cognitive & Behavioral | KELL-GLU4KJ (Illinois) | Secondary |
103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Paul Kelly is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Paul Kelly, 7921 S Trumbull Ave, Chicago, IL 60652-1454 Ph: (708) 728-5460 | Paul Kelly, 7921 S Trumbull Ave, Chicago, IL 60652-1454 Ph: (708) 728-5460 |
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